Oral prednisone in the treatment of acne agminata

Abstract

Acne agminata (lupus miliaris disseminatus faciei), once regarded as a tuberculide, is a facial granulomatous disease still seen in young adults in Japan, despite a decrease in the incidence of tuberculosis. Although most lesions regress within a few years, even without treatment, disfiguring scars remain on the face. We have evaluated the efficacy of low dose oral prednisone therapy because, in the past, there has been no satisfactory therapy for this condition. We have treated four patients with acne agminata with prednisone, at first 10 mg daily for 2 weeks, decreasing to 5 mg daily for 3 months. This modest dosage was found to give an excellent result in three patients and a poor result in one whose treatment was started at a much later stage of the disease than in the others. Acne agminata can be cured without scar formation when oral steroids are started in an early phase of the disease.

Lupus miliaris disseminatus faciei: A Distinctive Rosacea-Like Syndrome and Not a Granulomatous Form of Rosacea

“…However, the occurrence in young adults, the involvement of extrafacial sites and areas typically spared by rosacea, such as the eyelids and upper lip, the absence of vascular symptoms, such as flushing, erythema and telangiectasia, the therapeutic response to systemic glucocorticosteroids [11]and clofazimine [12], and the self-limited course with scarring all contrast with the concept of rosacea and suggest a different pathogenesis.…”

Papules in the Axillae of a Woman

“…Although multiple medical treatments, including tetracycline antibiotics, isotretinoin, dapsone, and topical and oral corticosteroids, can be effective in treating acne agminata, 1,3,5 reports of successful treatments for axillary acne agminata are few. No controlled studies exist, and treatment in many cases proves unsuccessful.…”

“…The patient was treated with low-dose oral prednisone therapy (10 mg/d for 2 weeks, decreasing to 5 mg/d for 3 months) with minimal improvement. 1 …”

F.I.GU.R.E.: Facial Idiopathic GranUlomas with Regressive Evolution

“…This treatment could be active via its antibacterial or its anti-inflammatory activities. Systemic steroid therapy with prednisone, 10 mg/day, could also be efficient if used soon after the onset of the disease [7]. More recently efficiency of clofazimine, 100 mg three times per week, has been described in 1 case [8].…”